Senate Committee Addresses Meaningful Use, Interoperability

March 18, 2015 in News

During a Senate Health, Education, Labor and Pensions Committee hearing on Tuesday, senators and stakeholders discussed issues regarding the meaningful use program and barriers to achieving interoperability, Healthcare Informatics reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Perna, Healthcare Informatics, 3/17).

Hearing Details on Meaningful Use

In an opening statement, Senate committee Chair Lamar Alexander (R-Tenn.) said that “evidence suggests” that while the meaningful use program has spent $30 billion, it has so far failed to deliver on its promises to “improve care, improve coordination and reduce costs.”

Specifically, Alexander noted that eligible professionals and hospitals have struggled with the program to the point where CMS has been forced to delay or update its requirements three times. He added, “Half of physicians have not met the requirements of the program and are now facing penalties” (Slabodkin, Health Data Management, 3/18).

Sen. Sheldon Whitehouse (D-R.I.) said he agreed with Alexander’s criticism of the program, noting that he “would love to work with [his] colleagues with rebooting meaningful use” (Tahir, Modern Healthcare, 3/17).

Specifically, Whitehouse criticized the meaningful use program’s failure to include nursing homes and behavioral health care facilities. He said, “If you don’t require nursing homes to cooperate, you’ve made a stupid tactical error in the rollout of health IT.”

Meanwhile, Robert Wergin, president of the American Academy of Family Physicians, in his testimony said the program’s requirements can be too stringent. In addition, he said that it can be difficult to obtain useful information from EHRs (Frieden, MedPage Today, 3/17).

Wergin recommended that the EHR incentive payment program:

  • Overhaul its documentation requirements to be less time-consuming for physicians; and
  • Remove penalties for noncompliance.

Alexander and Whitehouse both suggested that the committee hold ongoing meetings to address ways to improve the meaningful use program and EHR adoption (Healthcare Informatics, 3/17).

In a statement submitted to the Senate HELP Committee, the American Hospital Association also made several policy recommendations to give eligible hospitals more flexibility in meeting meaningful use requirements.

For example, AHA recommended that policymakers:

  • Delay the start date or requirements for Stage 3 until enough eligible hospitals and professionals have attested to Stage 2;
  • Not hold hospitals accountable for vendor-related technology delays; and
  • Shorten the program’s reporting period from one year to 90 days (AHA News, 3/17).

Meanwhile, some committee members, including Sens. Al Franken (D-Minn.) and Patty Murray (D-Wash.), praised the meaningful use program for bolstering EHR adoption among providers.

Murray said, “In 2001, only 18% of physicians used [EHRs] — and today, 78% do. That’s a real transformation” (Healthcare Informatics, 3/17).

Stakeholders Criticize Lack of Interoperability

Meanwhile, several stakeholders at the hearing criticized the lack of EHR interoperability, which they said has stifled technology’s effect on health care (Healthcare Informatics, 3/17).

Julia Adler-Milstein, an assistant professor at the University of Michigan, in her testimony said that technology is not the main barrier to interoperability (Mazmanian, FCW, 3/17). She noted that major barriers include:

  • Competition among health care providers; and
  • High costs and expenses.

In his testimony, Wergin called on policymakers to delay meaningful use penalties until interoperability has been achieved. However, Adler-Milstein noted that penalties could encourage providers to put pressure on vendors to improve EHR systems (MedPage Today, 3/17).

Meanwhile, Angela Kennedy — head of the Department of Health Informatics and Information Management at Louisiana Tech University Louisiana Tech University — in her testimony criticized the lack of information governance principles, saying, “If we continue with a narrow focus on technology and without a focus on information governance processes and principles, the U.S. will continue to experience daunting challenges related to health information exchange and sharing, patient identification and privacy and security.”

During the hearing, Sens. Tammy Baldwin (D-Wisc.) and Bill Cassidy (R-L.A.) also questioned Epic’s Director of Interoperability Peter DeVault about the vendor’s interface and refusal to join the Commonwell Health Alliance, an EHR vendor trade group working to improve interoperability (Healthcare Informatics, 3/17).

DeVault said that Epic has not joined Commonwell because the group:

  • Is expensive;
  • Lacks transparency; and
  • Intends to sell patient data.

In response to DeVault’s comments, Commonwell member Cerner in a statement said the “rhetoric is a slap in the face to many parties working to advance interoperability. It was discouraging to hear more potshots and false statements when it’s clear there is real work to be done.”

Meanwhile, Dan Haley of athenahealth called DeVault’s comments “nonsense.” He noted that the group’s “costs of participation are extraordinarily reasonable compared [with] the costs of, say, hiring platoons of Epic implementation consultants” (Allen et al., “Morning eHealth,” Politico, 3/18).

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